A combination of all the three miasms - psora, sycosis and syphilis

- BENERJEE.P,
 9. 2. 1916.
 Mr.-; age 31. Lost his character too early in life in the company of some young friends. The dissipation continued unabated for 4 or 5 years. The death of the father, which took place when he was very young, enabled him to inherit a big zemindary and as big an amount of hard cash. Thus, there was no difficulty in satisfying his vile greeds-no want of money and no check or control in the shape of a guardian. He made it a point to spend most of his time in Calcutta, and sued to go to his village only very occasionally, and that for very short periods of time, in connection with the affairs of his estate. He spent his days freely iu Calcutta and was surrounded there by a number of friends, who only helped him to ruin himself. But dissipation is bound to be soon followed by a reaction, and when his liver had actually reached a condition too frightening to be ignored, he was advised by Dr. Nilratan Sarkar, ta leave off his vile practices and all the attendant objects of enjoyment. The poor fellow was thus in great difficulty. Really, he could neither give off his enjoyments, as they had become indispensable for him by now, nor take to a sober life. But when he actually vomited a large quantity of pure blood one morning, he was roused to the reality of the situation. There was the arrogance so long that he had any amount of money, and money would have brought him cure, but when the spell of blood-vomiting appeared in spite of all the costly treatment he had uudergone, he seemed to be alive to the fact that money was not perhaps sufficient for giving cure always. He had already had gonorrhœa and syphilis, but as any long course of suffering from these would have interfered with the pleasures of his life, he got each of these removed by injection the quickest. As a matter of fact, he used to declare to his physicians, that the more quickly they could cure him, the more handsomely would they be rewarded; and it is understood that he had actually paid Rs. 1,000 to a physician in a single day, for having very kindly brought for him a very powerful injection from Germany by a special indent. This powerful injection was said to be so powerful as never to allow the gonorrhœa and the syphilis in the system, ever to make their appearances during the rest of his life. But as ill luck would have it, they made their appearances in all the ugliness of their symptoms, nullifying the assurances of his physician and ignoring the "powerfulness" of the injection. These will be described later on, but in the meantime, he was so badly suffering from dyspepsia that it really grew impossible for him to stay in Calcuttta. His physicians were unanimous in their opinion, and declared that Calcutta was to be left at once, and a change for some better place was absolutely necessary. He therefore, went on a change. By the way, I may say here exactly what the patient said to me about this advice for change.-"Whenever these Calcutta physicians find a paying patient, they begin to suck him. Yes, they suck him white, and when he is pretty near death's door, they advice a change of climate with all the characteristic gravity of their learning and profession, and thus free themselves of all responsibilities. They are, however, not slow to point out that they have done their best for the benefit of the patient, but as change of climate is the only thing necessary now, they give the advice for it, in the real interests of the patient, though in fact, it means a loss to them, because, as physicians they cannot but give their unbiased and disinterested advices. But, I do not know, if there is another fool like myself etc. etc."
 PAGE 396
 PAGE 397
 PAGE 398
 However, the patient went to his native village for a change on the advice of his physicians, and he went there with a dyspepsia that was threatening disaster. Fortunately, the village atmosphere did him some good, and he made up his mind never to go to Calcutta again. His father-in-law who was a renowned lawyer in Assam advised either Ayurvedic or Homœopathic treatment just at this stage. And the patient was now in a mood for listening to the advices of his father-in-law and wife, because his Calcutta friends, who were so near and dear to him, and who were being fed so long at his cost, and who were having all their enjoyments out of his money, were now hardly having time and leisure to enquire about his condition. Some of them were even in the habit of writing now, that they had always done their best to dissuade him from the vicious activities of his life, but he had never listened to them, and the present troubles were all due to his having ignored their advices, etc., etc. However, on the father-in-law's advice, a course of Ayurvedic treatment was first undergone in the hand of an able Kaviraj, but as this failed to do anything, and when the patient actually became bedridden, I was approached; and I made the following record:-
 Record (an exact translation of the patient's statement):-
 PAGE 399
 "I am a veritable scoundrel, and there is no sensual pleasure on earth that I have not had. I have now only to depend on your kindness and sympathy."-Just here, I asked him to keep to the subject, and he continued-"I contracted gonorrhœa at the age of 21, and syphilis only 5 or 6 months after that. These were removed by injections and external application of ointments of various kinds, but my health broke just here. I had therefore to use all sorts of medicines including patent medicines from that time. Dr. Nilratan Sarkar was my chief physician. Of course several other reputed physicians also used to treat me at times. However, at the age of 27, I was quite an old man. When 24 years old, I spat a large quantity of blood one morning. Of course, I grew cautious after this, but as my friends advised that drinking would cure the trouble, I did not give up drinking. It was only after I had become 26, that I actually gave off wine and woman. It is about 4 years now that I have not taken part in any kind of amusements, and the reason is the condition of my health."-I asked him to state out his symptoms and sufferings and he began.
 "I have a continuous vertigo, and there is a tendency for falling while walking. It is only by extreme carefulness that I avoid an actual fall. Then again, there is an indescribable pain within the head. At times, it seems, there are innumerable ants within and I feel their bites. This is generally more severe after a sleep. I get angry very easily, and any contradiction from anybody excites an irresistible impulse for beating him, as I cannot tolerate that there should be any contradiction to my views. It has become a habit with me to use off-hand rough words against all, and at times I abuse my wife and the servants for nothing. But, again, there is a repentance and even actual weeping, as soon as I become a bit sober after the angry fit. I then seem to think that all will combine and curse me for having abused them. There is a pain in the back and waist, and this is comparatively severer at night in the bed. There is a tendency for frequent urination, and after a flow, which is always scanty, there is a severe burning pain in the urinary canal. No sleep at night. All the history of my earlier misdeeds comes up in the mind and keeps me awake. I feel awfully miserable. Towards the morning, there is a rumbling in the abdomen and it is then followed by 8 or 10 loose motions. It gradually becomes more and more thin every time, and the last motion is as thin as water. The rumbling is awfully severe, and it really frightens me. There is perspiration; perspiration even on very slight exertion. It is fetid smelling, and the smell is garlicky. The evacation has also the same smell. There is craving for food, but absolutely no power of digestion. I have often seen undigested solid food being passed with the watery evacuations. There is burning in the hands and feet and on the vartex. Cannot tolerate cold. I prefer open air, but cannot tolerate cold air. Cold air brings on headache and fever. The rumbling and the watery motions continue up to 9 or 10 in the morning, and after that there is no trace of these, and then the appetite is quite like a normal man's. I take my food then. Bathe only occasionally and not every day, as I do not feel any inclination for it. I am worst in the rainy season, as then I get an accumulation of catarrh in the chest and nose, and this compels asthmatic breathing throughout the whole rainy season. This asthmatic breathing is most severe in the night. I have to sit up in the bed and cough and breathe like that during the whole night. The eyesight is bad, and I seem to look through the mist; and various colours seem to be floating before my eyes. I have piles too, and these are also aggravated during the rains and winter. There is severe cutting pain in the rectum, and also profuse flow of blood. This is however much less in summer. The most severe troubles at present, are about the urine and the stomach. In summer, there is a ringworm-like eruption on the abdomen and in the margin of the anus. These exude a highly fetid smelling, thick and sticky discharge. The smell is exactly like that of putrid flesh. There is itching, and itching is followed by pain."
 PAGE 400
 PAGE 401
 PAGE 402
 I stopped him just here and said,-"A thorough cure of all your troubles is possible only by bringing back the suppressed gonorrhœa and syphilis. But in the present condition of your health, such constitutional treatment is not possible, as you have not the vitality to stand the action of deep acting remedies. For the present, you require an immediate relief from the dyspepsia. When you have been relieved of the troubles in the stomach, and when you have recouped your health to a certain extent by a careful regulation of diet and movements etc, it will be possible to treat you for a thorough cure. Such treatment for a thorugh cure will, however, be necessary, as otherwise you will never keep well in your life, even for two days at a stretch, if the stomach only is corrected. Please therefore, let me know what else you have about the stomach troubles".
 On this the patient replied-"If an all round cure of my case is possible, by bringing back the gonorrhœa and the syphilis, and if diseases cured can at all be brought back by medicines, I have no objection. But pray, save me from this dyspepsia first of all".
 I then took up the dyspepsia and cured it in 15 or 16 days' time with Thuja-30 and 200, and then Sulphur-30 and 200. He was then kept on strict dietetic control for full three months; and when he gained some strength, I explained to him the mystery of chronic treatment and cure, and began his case on the 14th of June, after making the following further record:-
 PAGE 403
 Record (as taken for the second time, i. e. after the cure of the dyspepsia):-
 "All the symptoms, except the dyspepsia and the mental prostration, are still there. And I have the following troubles besides:-There is a sudden palpitation at times. There is rheumatism also at times. In cold weather and during rains, there is a soreness in the body. Memory is totally gone. Cannot remember things even a month or two old. Pray, do something to save me from the asthmatic troubles that will be coming on during the next rains."
 After a thorough study of the case, I prescribed Medorrhinum and gave the first dose of it in the 1,000th potency on 48. 6. 16, with instruction for reporting result after a fortnight. Sufficient placebo was also given for daily use.
 3. 7. 16. No gonorrhœal discharge yet, but there was a running of the nose. Medhorrinum-1,000, another dose and placebo.
 11. 7. 16. The gonorrhœa re-appeared, and the patient said that it was exactly as it was at the first time, but the prospect of cure had put courage in his mind. Placebo, twice daily.
 PAGE 404
 27. 7. 16. The discharge was almost disappearing. Another dose of Medhorrinum-1,000.
 3. 8. 16. The discharge was re-appearing again, but it was not so profuse this time. Placebo.
 14. 8. 16. The discharge had almost ceased. Medhorrinum-10 m, one dose, and placebo.
 27. 9. 16. No further re-appearance of gonorrhœa after the 10 m potency., but instead, there, came on a severe fit of asthma. It was most severe from 9 or 10 in the night till about day break. Natrum Sulph-200, one dose every morning until the asthma abated. And the asthma was appreciably less after 5 or 6 days.
 16. 10. 16. Asthma again-as severe as at the last time. Natrum Sulph-500, one dose only. The asthma became very severe on the 18th and 19th, and after that it gradually disappeared, and instead, there came out now eczema on the whole body except the face and chest. It was an awful sight to see. The whole body was covered with eczema and a putrid smelling discharge was rolling down in abundance, and the patient was itching now here and then there.
 18. 12. 16. Psorinum-c. m., one dose every morning for three days and then globule No. 10 twice daily.
 7. 4. 17. The eczema which was drying up, increased again. Psorinum-m m. one dose only.
 PAGE 405
 11. 7. 17. The eczema was totally gone, and the patient was much improved in the mind too. Gave some placebo, as there were no symptoms practically, to prescribe the next dose upon, though syphilis was still hidden in the system. The patient was feeling all right, and the few symptoms of fetid night sweats and vertigo etc. that were still persisting, were not enough for risking a prescription. I therefore waited on, in the expectation that syphilis must come out before long in all its own symptoms.
 24. 9. 17. Some ulceration in the mucous membrane of the nose came out. This gradually increased. There was pain in the left nostril, and some discharge of blood and pus. But as these few symptoms, besides the night sweat and vertigo etc. were not enough, I decided to wait on, for another fortnight, and gave some placebo for this period.
 9. 10. 17. The ulceration was quite characteristic now, and I gave Kali Bichrom.-200 in graduated doses. There was relief after a week.
 22. 10. 17. The ulceration was almost gone. Placebo for a fortnight.
 8. 11. 17. Kali Bichrom-1,000, one dose, and placebo for a month.
 5. 12. 17. The ulceration in the nose was totally gone, but the nose was running, and it seemed, there were repeated attacks of cold. Merc. Sol-10 m., one dose only. But, though I waited for full three months, the syphilitic chancre did not come out. And as the patient began to show want of interest and inclination for continuing the course of treatment further, I had to close the case with a dose of Tuberculinum-1,000, as called for by the frequent tendency for catching cold
 PAGE 406
 Remarks:-
 (1) While taking up a chronic case, if the patient is found to be suffering from any acute symptoms or from an acute exacerbation of the chronic disease, superficially acting remedies should be used at first and the acute condition subdued. Deep acting miasmatic remedies in high potencies should never be used at once in such cases, as that might bring on a severe aggravation and endanger the patient's life.
 (2) Where there are several miasms in a case, the remedy indicated by the symptoms of the miasm predominant at the time, should be selected, and not the remedy indicated by all the symptoms in the case. If this is done, the miasm thus struck at, will be subdued, and one of the other miasms will come out prominently, when a fresh selection will be necessary according to the symptoms thereof, and so on until the case is cured.
 (3) The curative course in cases where the primary manifestation of a miasm has been suppressed must bring that back, and this necessitates the use of high potencies. But the potency in such cases should always be fixed upon with due regard to the patient's vitality.

 (4) Where, however, the miasm is inherited and not acquired, there cannot possibly be any coming back of the primary manifestation, but in such a case too, the re-appearance of old symptoms in the reverse order of their coming would give positive indication of a true course of cure.
 (5) In the present case all the miasms of the patient were not eradicated, but this was due entirely to want of patience on the part of the patient.